Does the liner material influence pulpal vitality in deep carious cavities submitted to selective caries removal? A network meta-analysis review.

OBJECTIVES: To evaluate whether the restorative material in direct contact with the dentin influences pulp vitality in primary and permanent teeth with deep carious lesions restored after selective caries removal (SCR). MATERIAL AND METHODS: Systematic searches of databases MEDLINE via PubMed, Scopus and ISI Web of Science were performed for primary and permanent teeth. Inclusion criteria were applied for title and abstract reading of databases search results. After full texts review of included studies, those that did not meet exclusion criteria were excluded from meta-analysis. RESULTS: For meta-analysis, 2 studies were included for permanent teeth and 6 for primary teeth. The failure events reported were meta-analyzed using two statistical methods: standard pairwise meta-analysis (SPMA) and network meta-analysis (NMA). The SPMA identified similar failure occurrence of restorations performed with calcium hydroxide (CH) and other liner materials (RR 0.84, 95% CI 0.41, 1.74; p = 0.64), no significant difference between the use of alternative liners or CH regardless deciduous or permanent teeth (RR 0.79, 95% CI 0.36, 1.71; p = 0.55) and similar risk of failing at different follow-ups for all liner materials tested (RR 0.77, 95% CI 0.35, 1.70; p = 0.52). Probabilistic analysis indicated GIC as liner material with the highest probability of clinical success (SUCRA = 72.76%), and CH ranked as the worst liner material (SUCRA = 21.81%). CONCLUSION: Pulpal vitality was not affected by material used as liner after selective caries removal in deep carious cavities. CLINICAL RELEVANCE: Current clinical evidence supports the weak recommendation to not use calcium hydroxide as liner after SCR.

Self-etch Approach of Universal Adhesives as an Alternative to Minimize Bond Degradation on Sound Dentin vs Caries-affected Dentin over Time.

PURPOSE: To investigate the influence of the etching strategy of universal adhesives on bond degradation to sound and artificially-induced caries-affected dentin. MATERIALS AND METHODS: The universal adhesives (Scotchbond Universal Adhesive; All-Bond Universal; Prime&Bond Elect) and adhesives used as controls (Adper Single Bond 2 and Clearfil SE Bond) were applied to sound and artificially-induced caries-affected bovine dentin. Microtensile bond strength was evaluated immediately (24 h) and after one year of water storage (1 year). Representative specimens were also prepared to assess nanoleakage. Bond strength data (MPa) were analyzed using three-way ANOVA and post-hoc Tukey's test (α = 0.05), considering each substrate separately. RESULTS: Bonding degradation was observed for all universal adhesives on caries-affected dentin, irrespective of the etching strategy. On sound dentin, bonding degradation was observed when adhesives were used on the etch-and-rinse strategy. CONCLUSION: The universal adhesives were not capable of maintaining bond stability over time on caries-affected dentin. The self-etch strategy seems better able to maintain the durability of adhesive interfaces created on sound dentin.

Effect of different placement techniques on color stability and surface roughness of resin composites / Efeito das técnicas de inserção e alisamento na estabilidade de cor e rugosidade superficial de resinas compostas

Abstract Introduction Longevity and clinical success of dental restorations can be influenced by many factors during the restorative procedures. Objective This study aimed to evaluate the influence of different placement techniques on color stability and surface roughness of two resin composites. Material and method The groups of specimens (n=10) were divided according to resin composite (FiltekTM Z250 XT and FiltekTM Z350 XT) and placement technique: Mylar strip, spatula, dry brush, modeling liquid, and surface sealant. Color stability and surface roughness were accessed using a spectrophotometer (CIELab color space) and a rugosimeter (standard cutoff of 0.8 mm), respectively, after water storage. Subsequently, the specimens were immersed in coffee for 48 h and final color was measured. The data were analyzed using ANOVA and the Tukey's post hoc test (α=5%) and the correlation between surface roughness (Ra) and color change (∆Eab) was assessed using the Pearson's correlation coefficient. Result The different placement techniques influenced Ra and ∆Eab on both resin composites. The groups treated with surface sealant showed greater difference in ∆Eab for both resin composites. The FiltekTM Z250 XT resin showed greater color stability compared with the FiltekTM Z350 XT resin regardless of the placement technique used. Ra of each placement technique was similar among the resin composites except for the FiltekTM Z350 XT modeling liquid group, which presented lower Ra values compared with those of FiltekTM Z250 XT. A correlation between Ra and staining was identified (p=0.268). Conclusion Color stability and Ra are influenced by different placement techniques.

Resumo Introdução A longevidade e o sucesso clínico das restaurações dentárias podem ser influenciados por muitos fatores durante os procedimentos restauradores. Objetivo Avaliar a influência da técnica de alisamento na estabilidade de cor e rugosidade superficial de duas resinas compostas. Material e método Os grupos de amostras (n=10) foram divididos conforme a resina composta (FiltekTM Z250 XT e FiltekTM Z350 XT) e as técnicas empregadas: tira de poliéster, espátula, pincel seco, selante de superfície. A cor e a rugosidade da superfície foram avaliadas por espectrofotômetro (espaço de cor CIELab) e rugosímetro (corte padrão de 0,8 mm), respectivamente, após o armazenamento em água. Posteriormente, as amostras foram imersas em café por 48h e a cor final foi aferida. Os dados foram analisados usando teste ANOVA e Tukey post hoc (α = 5%) e a correlação entre rugosidade da superfície (Ra) e variação de cor (∆Eab) através do coeficiente de correlação de Pearson. Resultado As técnicas de alisamento influenciaram a Ra e a ∆Eab em ambas as resinas compostas. Os grupos tratados com selante de superfície apresentaram maior diferença na ∆Eab. A resina FiltekTM Z250 XT apresentou maior estabilidade de cor comparada à FiltekTM Z350 XT, independentemente da técnica utilizada. A Ra das técnicas de alisamento foi semelhante entre os compósitos, exceto para o grupo do líquido modelador da FiltekTM Z350 XT, que apresentou os menores valores. Uma correlação entre Ra e manchamento (p = 0,268) foi identificada. Conclusão A estabilidade da cor e a Ra são influenciadas pelas técnicas de alisamento utilizadas.

The impact of artificially caries-affected dentin on bond strength of multi-mode adhesives.

AIM: The aim of this study is to evaluate the impact of dentin condition on bond strength of multi-mode adhesive systems (MMAS) to sound and artificially induced caries-affected dentin (CAD). METHODS: Flat dentin surfaces of 112 bovine incisors were assigned to 16 subgroups (n = 7) according to the substrate condition (sound and CAD- pH-cycling for 14 days); adhesive systems (Scotchbond Universal, All-Bond Universal, Prime and Bond Elect, Adper Single Bond Plus and Clearfil SE Bond) and etching strategy (etch-and-rinse and self-etch). All systems were applied according to the manufacturer's instructions, and resin composite restorations were built. After 24 h of water storage, specimens were sectioned (0.8 mm2) and submitted to the microtensile test. STATISTICAL ANALYSIS: Data (MPa) were analyzed using three-way analysis of variance and Tukey's test (α = 0.05). RESULTS: MMAS presented similar bond strength values, regardless etching strategy in each substrate condition. Bond strength values were lower when MMAS were applied to CAD in the etch-and-rinse strategy. CONCLUSION: The etching strategy did not influence the bond strength of MMAS to sound or CAD, considering each substrate separately. However, CAD impact negatively on bond strength of MMAS in etch-and rinse mode.

Effect of a surface sealant on the color stability of composite resins after immersion in staining solution.

This study evaluated the influence of surface sealants on the color stability of 2 different composite resins after immersion in coffee. Four groups were created (n = 10): microhybrid composite, microhybrid with surface sealant, nanofilled composite, and nanofilled composite with surface sealant. Half of the specimens of each group were immersed in distilled water and half were immersed in coffee for 48 hours. Color was measured before and after immersion. Groups with surface sealants presented less color variation when compared with the groups without surface sealants. The nanofilled resin specimens presented the greatest color variation within the groups without sealant. The surface sealant positively influenced the color stability of composite resin specimens immersed in coffee. When surface sealant was not applied, the microhybrid specimens had better color stability than the nanofilled.

Tratamento conservador estético de manchas hipoplásicas: relatos de casos / Esthetic conservative treatment of enamel hypoplasia: case reports

A hipoplasia de esmalte insere-se como um dos fatores que podem causar desarmonias estéticas do sorriso, principalmente quando acomete dentes da bateria anterior. Uma abordagem minimamente invasiva, com associação de técnicas conservadoras, apresenta-se como correta indicação para a recuperação estética desses dentes. O presente artigo relata, mediante a exposição de dois casos clínicos, a associação de clareamento dental, microabrasão e macroabrasão, seguida de restaurações com resinas compostas, e a microabrasão foi empregada apenas em um dos casos clínicos. A satisfação das pacientes, juntamente com os resultados clínicos obtidos, comprova a efetividade do tratamento.

Enamel hypoplasia is a common cause of esthetic disharmony, especially when it affects anterior teeth. Minimally invasive approaches are the first option to restore this type of enamel defect. This article presents two case reports of the association of tooth whitening, microabrasion and macroabrasion followed by composite resin restorations. Microabrasion was used only in one of the cases. Patients’ satisfaction, along with clinical results, proved the effectiveness of the association of these treatments.